| State Of Connecticut | |
|
Silver Street Dutton Home Middletown CT 06457 | |
| (860) 262-5224 | |
| (860) 262-5359 |
| Full Name | State Of Connecticut |
|---|---|
| Speciality | Clinic/Center |
| Location | Silver Street, Middletown, Connecticut |
| Authorized Official Name and Position | Stephen A Dipietro (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8604186923 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| State Of Connecticut Silver Street Dutton Home Middletown CT 06457 Ph: (860) 262-5224 | State Of Connecticut Silver Street Dutton Home Middletown CT 06457 Ph: (860) 262-5224 |
| NPI Number | 1427074426 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 03/16/2016 |
| Medicare PECOS PAC ID | 8022915677 |
|---|---|
| Medicare Enrollment ID | O20040319000365 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427074426 | NPI | - | NPPES |
| 004120151 | Medicaid | CT | |
| 004214946 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Marc L Zekowski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326143736 PECOS PAC ID: 4688567514 Enrollment ID: I20040205000031 |
| Provider Name | John M De Figueiredo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942271739 PECOS PAC ID: 8123915758 Enrollment ID: I20040301000040 |
| Provider Name | Sonya Lee Kelly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427152990 PECOS PAC ID: 9436136421 Enrollment ID: I20040707001064 |
| Provider Name | Margaret A Meskill |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750405759 PECOS PAC ID: 3476594615 Enrollment ID: I20050518000101 |
| Provider Name | Diana C Vincenzo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528108354 PECOS PAC ID: 4385689363 Enrollment ID: I20050621000348 |
| Provider Name | Catalin Pralea |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225126014 PECOS PAC ID: 1658309406 Enrollment ID: I20050802000630 |
| Provider Name | Eric Brysgel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912950213 PECOS PAC ID: 6709817943 Enrollment ID: I20050826000509 |
| Provider Name | Rebecca H Frost |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700952215 PECOS PAC ID: 1153349857 Enrollment ID: I20051110000317 |
| Provider Name | Brenda L Planck |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417929068 PECOS PAC ID: 5496776544 Enrollment ID: I20060209000243 |
| Provider Name | Rose E Persico |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942372701 PECOS PAC ID: 0648270660 Enrollment ID: I20061221000460 |
| Provider Name | Charles B Baker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184782013 PECOS PAC ID: 1456452101 Enrollment ID: I20070724000740 |
| Provider Name | Kyleen J Zaleski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477756930 PECOS PAC ID: 2062503592 Enrollment ID: I20070813000169 |
| Provider Name | Benay P Smith |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1811156177 PECOS PAC ID: 9830262138 Enrollment ID: I20080721000051 |
| Provider Name | Robin C Swetz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346316544 PECOS PAC ID: 5294801577 Enrollment ID: I20080910000564 |
| Provider Name | Albert R Cagganello |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801052238 PECOS PAC ID: 2264591403 Enrollment ID: I20081105000424 |
| Provider Name | Paul G Dalessio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467578229 PECOS PAC ID: 5395892855 Enrollment ID: I20090421000012 |
| Provider Name | Christopher Gash |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689642175 PECOS PAC ID: 6800946039 Enrollment ID: I20090610000381 |
| Provider Name | Joanne S Baloga |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144450834 PECOS PAC ID: 8224183819 Enrollment ID: I20090903000303 |
| Provider Name | Joanne E Comstock |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033340302 PECOS PAC ID: 6103962626 Enrollment ID: I20091013000763 |
| Provider Name | Rebecca C Stamat |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548594633 PECOS PAC ID: 7416093901 Enrollment ID: I20091014000482 |
| Provider Name | Maria Patrascu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306925284 PECOS PAC ID: 7214126432 Enrollment ID: I20110104000692 |
| Provider Name | Nikolai Lieders |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396813051 PECOS PAC ID: 3577744762 Enrollment ID: I20110222000103 |
| Provider Name | Mohammed S Simjee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235205444 PECOS PAC ID: 7911181755 Enrollment ID: I20110404000020 |
| Provider Name | Elizabeth Fernandes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851697650 PECOS PAC ID: 2668658824 Enrollment ID: I20110524000241 |
| Provider Name | Kristin Sorlie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164845756 PECOS PAC ID: 8123259868 Enrollment ID: I20140324000492 |
| Provider Name | Lesley-ann Bernard-pantin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851515951 PECOS PAC ID: 1153412531 Enrollment ID: I20150109000117 |
| Provider Name | Danielle Mcquillar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629392907 PECOS PAC ID: 0941590475 Enrollment ID: I20160613000122 |
| Provider Name | Debra Bloom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972655694 PECOS PAC ID: 8527352319 Enrollment ID: I20160802000608 |
| Provider Name | Juliann Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831592013 PECOS PAC ID: 1557655602 Enrollment ID: I20160811002037 |
| Provider Name | David Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992994321 PECOS PAC ID: 7810283058 Enrollment ID: I20160914000920 |
| Provider Name | Andrea Lafaro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558719070 PECOS PAC ID: 8820374523 Enrollment ID: I20170412001015 |
| Provider Name | Christina Barbara Welte-lake |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164653226 PECOS PAC ID: 9931460565 Enrollment ID: I20180222002239 |
| Provider Name | Alma Rosa Barreto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114462751 PECOS PAC ID: 4789949801 Enrollment ID: I20180521000647 |
| Provider Name | Michelle Mcnickle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821555350 PECOS PAC ID: 0345580726 Enrollment ID: I20190321001222 |
| Provider Name | David Horn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780135012 PECOS PAC ID: 6709200686 Enrollment ID: I20200724001112 |
| Provider Name | Charisse Weston-keldo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235648205 PECOS PAC ID: 8820418452 Enrollment ID: I20201020000982 |
| Provider Name | Shelley Beth Kingsbury |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104462654 PECOS PAC ID: 3779993415 Enrollment ID: I20201108000000 |
| Provider Name | Ayanna K Henry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467911743 PECOS PAC ID: 4880008010 Enrollment ID: I20210130000025 |
| Provider Name | Justin Damon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871187583 PECOS PAC ID: 7416366190 Enrollment ID: I20210510001788 |
| Provider Name | Jessica Lynn Hooper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649853870 PECOS PAC ID: 5597167643 Enrollment ID: I20210712002502 |
| Provider Name | Shannon L. Mazur |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225491152 PECOS PAC ID: 1658665195 Enrollment ID: I20210929000462 |
| Provider Name | Courtney W. Augustine-palmer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043737653 PECOS PAC ID: 4880092931 Enrollment ID: I20211005000781 |
| Provider Name | Joette Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669862058 PECOS PAC ID: 5890183586 Enrollment ID: I20211029001037 |
| Provider Name | Brittany Lee Ciarcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508312745 PECOS PAC ID: 4981095296 Enrollment ID: I20211221002138 |
| Provider Name | Kara Aniballi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841923034 PECOS PAC ID: 1759753080 Enrollment ID: I20230214001084 |
| Provider Name | Danielle Kleczkowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194366658 PECOS PAC ID: 3971976861 Enrollment ID: I20230223001001 |
| Provider Name | Lynnell Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053904466 PECOS PAC ID: 2365816535 Enrollment ID: I20230330000944 |
| Provider Name | Timothy Jean Schlehofer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679286413 PECOS PAC ID: 5799143467 Enrollment ID: I20230628001707 |
| Provider Name | Kori Ellen Hames |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891419578 PECOS PAC ID: 5991150724 Enrollment ID: I20231013000200 |
| Provider Name | Mary Ann Yarbrough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710324769 PECOS PAC ID: 7618326166 Enrollment ID: I20231211000205 |
| Provider Name | Paula Zepke |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790130409 PECOS PAC ID: 1759734791 Enrollment ID: I20240126000244 |
| Provider Name | Denise Parent |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1881805513 PECOS PAC ID: 6608217401 Enrollment ID: I20240510001645 |
| Provider Name | Arcola Renee Bowden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487399432 PECOS PAC ID: 5890233639 Enrollment ID: I20240812003520 |
| Provider Name | Latanya Manu |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1104285782 PECOS PAC ID: 9436699485 Enrollment ID: I20240905002581 |
| Provider Name | John David Filip |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467747279 PECOS PAC ID: 0941735302 Enrollment ID: I20241121002073 |
| Provider Name | Erlinda Mercado |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790898278 PECOS PAC ID: 0446216782 Enrollment ID: I20250128001733 |
One Piece Of The Puzzle, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 460 Smith St, Suite L, Middletown, CT 06457 Phone: 860-990-0776 Fax: 860-904-2839 | |
Pursuecare Connecticut Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 101 Centerpoint Dr Ste 105, Middletown, CT 06457 Phone: 860-317-5251 Fax: 860-469-2766 | |
Mindrise Consulting Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 54 Forest St, Middletown, CT 06457 Phone: 203-999-2777 | |
The Connection, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Roscommon Dr, Middletown, CT 06457 Phone: 860-343-5500 Fax: 860-343-5509 | |
Lifted, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 49 Randolph Rd, Middletown, CT 06457 Phone: 860-334-6135 | |
Blue Hills Behavioral Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11 S Main St, Middletown, CT 06457 Phone: 860-852-3860 Fax: 860-852-3860 | |
Whole Heart Art Therapy & Creative Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 955 S Main St # B201, Middletown, CT 06457 Phone: 203-533-2351 |